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Women Empowerment and Access to Maternity and Reproductive Healthcare in Pakistan: Cross-Validation of a Survey-Based Index in Afghanistan (Swei-A) Publisher Pubmed



Dadras O1, 2 ; Dadras M3 ; Jafari L4 ; Nakayama T5 ; Dadras F6
Authors
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Authors Affiliations
  1. 1. Department of Global Public Health and Primary Care, University of Bergen (UiB), Bergen, Norway
  2. 2. Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
  3. 3. School of Nursing, Zahedan University of Medical Sciences, Zahedan, Iran
  4. 4. Department of Public Health and Nursing, School of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  5. 5. Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
  6. 6. Department of Gynecology and Obstetrics, Graduate School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Women's Health Published:2022


Abstract

Background: Despite the obvious violation of women’s rights in Pakistan and the vital necessity for women empowerment, a unified country-specific index measuring women empowerment is not yet available. This study cross-validated a survey-based women empowerment index from Afghanistan to be used in Pakistan. Methods: The data for married Pakistani women aged 15–49 in the 2017–18 Pakistan demographic health survey was used to construct the final model using the explanatory and confirmatory factor analyses. The Cronbach’s alpha test examined the internal consistency of the developed index. To assess the convergence validity of the index, the association of each emerged domain with indicators of access to reproductive and maternity care was assessed by Poisson regression analysis adjusting for wealth index. Results: The final index had six domains; namely, labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events predicting women empowerment of married Pakistani women with decent reliability (Cronbach’s α = 0.70), and validity (SRSEA&SRMR < 0.05, CFI&TLI > 0.92). The emerged domains were significantly associated with at least one of four indicators for access to reproductive and maternity care; indicative of a favorable convergence validity. Conclusion: Pakistan and Afghanistan are associated as brother countries with shared religious and ethnocultural identities in which women are perceived inferior to men and in critical need of empowering efforts. The results of this study reflect upon this resemblance in sociocultural structure by yielding similar domains for women's empowerment in Pakistan building upon an index previously developed for Afghan women. The developed index could inform the design of future policies, interventions, and research recognizing the important indicators of women empowerment in Pakistan and could enhance the comparability of the results across future studies. © 2022, The Author(s).